Gohlke F, Wandel E, Christmann M, Meyer zum Büschenfelde K H, Hermann E
I. Medizinische Klinik und Poliklinik, Universität Mainz.
Dtsch Med Wochenschr. 1995 May 26;120(21):753-7. doi: 10.1055/s-2008-1055404.
For 10 weeks a 25-year-old man had been suffering from tiredness, fatigue, nausea and a 16 kg weight loss. Erythrocyte sedimentation rate (83/133 mm), serum C-reactive protein (5.5 mg/dl) and creatinine (5.05 mg/dl) were all elevated. He also had proteinuria (1120 mg daily), sterile leukocytosis and a creatinine clearance of 10 ml/min. Renal biopsy showed interstitial nephritis and bone marrow biopsy revealed non-caseous epithelioid-cell granulomas. 14 days after admission he developed acute iritis in the right eye. Other causes having been excluded, the diagnosis of tubulo-intestinal nephritis with uveitis (TINU syndrome) was made. The clinical symptoms and laboratory findings improved within a few days of the start of glucocorticoid treatment (initially, 100 mg prednisone daily, reduced to 5 mg within 30 days). The patient was discharged after 8 days in good general condition.
一名25岁男性持续10周感到疲倦、乏力、恶心,体重减轻了16千克。红细胞沉降率(83/133毫米)、血清C反应蛋白(5.5毫克/分升)和肌酐(5.05毫克/分升)均升高。他还存在蛋白尿(每日1120毫克)、无菌性白细胞增多,肌酐清除率为10毫升/分钟。肾活检显示间质性肾炎,骨髓活检发现非干酪样上皮样细胞肉芽肿。入院14天后,他右眼出现急性虹膜炎。排除其他病因后,诊断为肾小管间质性肾炎伴葡萄膜炎(TINU综合征)。糖皮质激素治疗开始几天后,临床症状和实验室检查结果有所改善(最初每日口服100毫克泼尼松,30天内减至5毫克)。患者8天后出院,总体状况良好。